- Molina Healthcare (Tampa, FL)
- …solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. * ... and collaborate cross-functionally to drive data-informed decisions in clinical and business operations . * Maintain fluency in healthcare data types (eg, ICD/CPT… more
- Molina Healthcare (Orlando, FL)
- …technical solutions. + Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and ... and collaborate cross-functionally to drive data-informed decisions in clinical and business operations . + Maintain fluency in healthcare data types (eg, ICD/CPT… more
- Molina Healthcare (St. Petersburg, FL)
- …Experience** + 0-2 years of experience in data analytics, business intelligence, or healthcare operations + Foundational proficiency in SQL and exposure to ... Python or another programming language + Basic familiarity with healthcare data types such as claims , encounters, or eligibility data + Comfortable working with… more
- Aveanna Healthcare (Miami, FL)
- Home Health RN Executive Director of Operations ApplyRefer a FriendBack Job Details Requisition #: 207426 Location: Miami, FL 33166 Category: Nursing Salary: ... responsible for the administrative and leadership functions associated with all operations of an Aveanna branch. Additionally, this individual is responsible for… more
- Molina Healthcare (St. Petersburg, FL)
- …highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and compliance of ... operations + Must have strong understanding of QNXT claims processes + Must be able to identify and...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Humana (Tallahassee, FL)
- … operations , technology, communications, and processes + Solid understanding of healthcare operations , particularly around claims processing, enrollment, ... meetings to discuss IT priorities, new requests, and collaborate with Market Operations and Compliance teams. Facilitate and communicate with state agencies on… more
- Molina Healthcare (St. Petersburg, FL)
- … operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms (eg, ... related to cost, utilization and revenue for multiple Molina Healthcare products. Analyzes data and dashboard reports to monitor...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (Jacksonville, FL)
- … operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms (eg, ... related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (St. Petersburg, FL)
- …outcomes and benefit realization + Demonstrates deep understanding of Core Operations , Claims and Enrollment processes, deliverables, vendor partners and ... productivity, quality, compliance + Articulates the goals and objectives of Molina Healthcare business units to vendors supporting operations of those units… more
- Molina Healthcare (St. Petersburg, FL)
- …CMS timelines. 2. Workflow Integration - Embed CTM insights into downstream operations -Stars, appeals & grievances, enrollment, claims -so each team addresses ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more